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Ep.55: With AAFPRS Member Dr. Mike Nayak


AAFPRS Member Dr. Mike Nayak

Tune in with Mike Nayak, MD of Nayak Plastic Surgery, An AAAHC accredited surgical facility, and of Avani Derm Spa in St. Louis. Hear how this successful practice, which has a 41 person team, has been able to cope and maintain through the uncertainty of the COVID-19 crisis. Get solid advice for your own practice and not just survive, but thrive.

Dr. Nayak’s Website

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Catherine Maley, MBA: Hello and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery. I’m your host, Catherine Maley, author of Your Aesthetic practice: What Your Patients Are Saying and consultants of plastic surgeons to get them more patients and more profit. Now, today’s special guests, I love this because he’s the newer up and coming plastic surgeon. He’s a younger guy but then he just told me he’s not that young. So, I’m getting really old because– anyway, he’s mid. So, let me just tell you about him. It’s Dr. Mike Nayak of Nayak plastic surgery and Avani Derm Spa. Now Dr. Nayak is a Board-Certified facial plastic surgeon in private practice. He has been for the last 14 years in [inaudible 01:01] Missouri, and actually is 15 miles outside of St. Louis, Missouri. He’s actually got two locations and we’ll talk about those. Now. He’s a graduate of Yale University where he majored in molecular biophysics and biochemistry and he’s earned his medical degree from Washington University. Now Dr. Nayak did his residency at Harvard Medical School and general surgery at Massachusetts General Hospital at the Massachusetts eye in near infirmary. He then completed a fellowship with the Glasspool group for plastic surgery and is an active member of the American Academy of Facial Plastic and Reconstructive Surgery as well as the American Academy of cosmetic surgery. And he regularly presents at the national meetings. Now, Dr. Nayak specializes in rhinoplasty facelift and injectables. And his private practice includes a state-of-the-art accredited surgical facility, as well as a Avani Derm Spa that offers non surgical services such as facials, makeup, spray tan, waxing, injectables, CoolSculpting and lots of other lasers and we’ll talk about his business setup. And he also started his own skincare line under the name of Avani. Now his humanitarian efforts include an annual trip to handily Vietnam to provide reconstructive surgical services as well as to teach local surgeons his own innovative techniques. Now, Dr. Nayak also offers pro bono rhinophyma reduction services to those who qualify. Now, to keep him and all of these profit centers running smoothly, it looks to me from what I found on his team photo on his website, he’s got a team of over 41 people and that includes his wife. So welcome, Doctor, to Beauty and the Biz

Dr. Mike Nayak: Thank you for having me, I really appreciate it.

Catherine Maley, MBA: Sure, no problem. So of course, we have to still talk about COVID because that’s still the number one conversation. So, what’s happening in Missouri with COVID in with your practice?

Dr. Mike Nayak:  Well, like everyone else, Friday, the 13th of March was kind of our last real day. And that weekend, it became pretty evident that we really couldn’t operate. The note is at non essential business. And we did have some local peers that kept on right through the lockdown under the auspices of being a doctor’s office. But I like to joke all the time, I used to be a doctor or not a real doctor’s office anymore. And so, we close down and we remained completely closed through the 18th of May. So, Missouri is a little bit of a wild west kind of state man. Our government is very localized, it’s not very state led. So, the state pretty much says okay, you local counties decide what to do more than the state governments can take over. So, the state government has been more lenient or that kind of stuff so far. But our local county St. Louis County has been a little tighter. So may 18, was when St. Louis County said that certain non essential businesses could start to reopen. So may 18, just two months into lockout is when I started doing surgery again, elective surgery again. And so, we started with that because it’s a subset of our staff. It’s maybe six staff members that need to come in for that. It’s one or two patients a day that we could realistically PCR COVID tests. And we can start just a small group work out the kinks a little bit. So, we did a week from May 18, which was a Monday through the end of that week. Just getting back into that feel of actually being back at work and a very limited number of people. May 25, the week later was Memorial Day. So, the day after that Tuesday, we brought back the rest of the staff. But we didn’t see any patients so we just had the– Depends on the day, we have 45 and 50 staff members so we had– the staff come back population to two offices but just getting used to all the new routines, how to check in and how to screen and how to wear your [inaudible 05:07] and what’s appropriate, what circumstances. And we got the news to treating, wearing all this stuff, because we had almost 50 staff members that had not had their treatments in two months. So that was a way for us to let the staff get all their treatments again. So, they’re all happy. And it was a way for the staff– on the treating and practice of doing treatments were in this cumbersome GP. So that was the second week that we were open. And then June 1st was the third week that we were open. And that was when we kind of opened up to patients in general, probably at about 70% scale so that we could have an adequate breaks and sanitation and that kind– and I also just get the step up to chance take the mask off, catch the breath and all that kind of stuff.

Catherine Maley, MBA:  

By the way you did one of the best COVID safety video that I’ve ever seen. If anyone gets a chance, you have to go to Nyack plastic surgery, calm Instagram, and he’s got all his staff in his video, who was the director, it’s almost like a production. That I mean, you put some effort into that video, and it was so carefully laid out. All the staff is involved, and you’re explaining to a patient, because what are the two biggest issues for the patient right now, safety, and the economy? There’s two big decisions for all of us. So you handle them beautifully. Like this is what to expect when you come in and you went step by step by step. That was excellent. How long did that take to shoot?

Dr. Mike Nayak:  

Well, I’ll tell you, so I’m really blessed with an amazing staff. So what I did is I wrote the I wrote the screenplay, if you will, the various scenes and lines. And then I actually have an employee as my social media director, Jenna, and I love to give her a little shout out here. So I communicate the agenda. Here’s the screenplay. And then here’s my vision for what I want to happen. And because of this, I want each staff member to know we’re walking through steps A through Z. And so we want to be patient to be able to see what this is going to look like. But be told by the familiar not just me lecturing for five minutes to be told by the various familiar friendly faces in our staff. And that was a peak COVID time. So we couldn’t really have Jenna filmed the staff member unless the staff member is wearing a mask. And then that’s not a really good. That’s not a really good visual to have someone talking through a mask at you. And so we did actually, as I wrote the screenplay, and I told Jen, I wanted her to assign a line and each line of what we want to an individual staff member, and then just split them out in different parts of the building. And they actually sell feed each line. And that way, simultaneously 15 or 20 people have me were involved in video, simultaneous or out there recording their line until they were happy with it. And then they they sent back their raw material to Jenna, she edited it, we had that whole thing down like four hours.

Catherine Maley, MBA:  

No kidding. I last time I looked you had over 2000 views on that instant, but it was killer, I highly recommend everybody starts thinking that way and if you can get that staff person, I was thinking, are you literally doing your own social media? Because that was a big deal. So you’ve got a good person on staff? I think I frankly think that, um, well, we’ll talk about marketing later. But I think everyone’s going to have a videographer on staff and a social media director on staff. I think you have to. Yeah, are so let’s just talk about you have a very unusual business structure. Because you’ve got the staff did it did all the staff come back? I mean, how, what happened to everybody?

Dr. Mike Nayak:  

So that’s really interesting. So all but one of our staff that we started with at the lockdown, all that one has returned, and that one is telling so much online product now through our online channels that she’s effectively replacing her original revenue, she’ll probably still come back anyway. But she’s, she’s particularly she’s got personal reasons to be particularly cautious right now. And so when she does come back, I know she will, but I’m not sure if it’s going to be in the next week or two. Until then she’s actually replacing her take home quite nicely just with online skincare, which is fantastic. And we’ve hired like six more, because there are new jobs or it takes it takes 1.25 X the effort to execute one extra work compared to pre COVID. So there’s a whole new job called the gatekeeper someone to set up the front door and screen temperatures and oxygen saturations and orchestrate getting in and out of cars and all that kind of stuff. That’s it that takes a human being. And if we’re open 50/60 hours a week in two locations, that’s 120 hours. That’s three full time employees so we’ve actually added like four or five part time employees to capture those 120 hours worth of extra work. So everyone came back minus one, and we’ve added four or five more.

Catherine Maley, MBA:  

Did you extend your hours to try to cover for the loss of the volume that you used to enjoy?

Dr. Mike Nayak:  

No, it’s interesting. So it’s every every decision that we make is there’s always a tension between what’s the plus and what’s the minus. And when we got, we had a few meetings leading up to reopening few virtual meetings leading up to reopening and there was significant hesitation, and significant kind of it wasn’t, it wouldn’t have been great if we said, let’s extend hours. And I can understand because at that point, there was still no path. There was no, there were no camps open. There were no daycares open so if we extend hours, who’s gonna? Who’s gonna watch these kids? You know what I mean? So it wasn’t, it wasn’t just like, a lot of my peers were like, oh, we’re gonna extend hours to make up for the slope people, I’m missing two months. We could have maybe forced the issue but it was. We really have to balance happiness, like team happiness with patient happiness. It’s not even about revenue. It’s about patients want to get in. There’s only so many slots, but the team has to have a life to do I mean, so we did not extend hours, the short answer?

Catherine Maley, MBA:  

How much do you think you have decreased your flow, percentage wise, due to all the new precautions that you have?

Dr. Mike Nayak:  

So surgery is as busy as it ever was, because that’s, I can fill surgery all day. And it’s only two to three human beings, human beings, two or three patients, because facial surgery is slow. And those might be two hours and a full face rejuvenation might be all day. And so I’ll do two to three procedures a day, so that two to three is the same. The non surgical side. And, again, we’ve only been open on the non surgical side for 21 days now. We started to flow like probably 60% 70%. The first week, I’d say now we’re probably up to 80 plus percent, but it’s because everyone was a lot of people are nervous to come back, like actual staff members were. That’s why I did that pre opening week where everyone just was with each other. I mean, you have to resocialize human beings or they’re not used to being outside their house, leave alone the crowd with other people wearing the sport and stuff like in the LR like we’re so used to wearing masks, we don’t care. You put that on your medical system and it’s just very fun. So, we started slow, we are steadily ramping up, as we have more confidence. And as the systems become easy you you don’t start off swimming three miles a day, you start off swinging a quarter mile maybe. And as you become efficient, then you can extend it. So for the last couple weeks, we’ve been more efficient or probably 85%. That’s probably what it will stay for a little while.

Catherine Maley, MBA:  

Did anybody get sick at all?

Dr. Mike Nayak:  

Not so far? We all know in St. Louis, we all know people who have been sick. We mean that with the large staff, statistically, someone’s going to get sick at some point, but we don’t have any staff members yet.

Catherine Maley, MBA:  

Very lucky. Good for you. Yeah. Oh, did it hit Missouri very hard?

Dr. Mike Nayak:  

It didn’t hit Missouri hard, it’s in Los County, where I live, it’s Los County. We have the cases in Missouri, most of them in our accounts.

Catherine Maley, MBA:  

Mm hmm. As long as we’re talking about staff, and business, who’s managing all these people?

Dr. Mike Nayak:  

That’s a great question. So I have I have. So obviously, my wife is still involved in the practice and kind of as an inside outsider, so she does not work there hours a day or even every day of the week. But when she comes in, she’s very good at kind of structure and noticing things and suggestions and ideas and kind of business development kind of thing. But that’s just as she sees opportunities. It’s not a structured position. My two, kind of real leadership team in the office is my office administrator and my office manager, I have two different people in the office manager is what you just ask HR, payroll, minor stats between people enforcing rules, congratulating people recognizing good behavior, hiring, firing, employee files, health insurance, all that kind of stuff. That’s the office manager. And it’s just so it’s kinda like office Mom literally kind of getting the sense that someone is literally talking about their problems at home, like that’s office manager. And that person has been with me a little over 10 years. She’s outstanding, is really, really good. She started out as an aesthetician actually. Yeah. So she was my office manager by the time she was 29, which is kind of weird. Like, you put a multimillion dollar business stands, but 29 year old Yeah, but she’s, she’s great. So that’s her. And then the office administrator is more. You almost think it was like director of implementation, like she’s the one that gets stuff done. So

Catherine Maley, MBA:  

co

Dr. Mike Nayak:  

What’s that? like to see? Oh, yeah. So you know if I say I’m looking to change my phone service, investigate three or four Voice over IP platforms, and then come to me with a digested presentation of what you looked at and what you saw and what your recommendations are. And so I won’t hear about that for three or four days, and we’ll come back with a package or if I want to implement she’s also kind of my in house IT person. So if you think of, like the legal analog would be big companies have an in house lawyer that in house lawyer can’t do all the legal work themselves are not specialists in all the different things that they might need to do. But they can hire the specialist and speak their language and and, and manage those specialists while they do the actual heavy lifting and then the in house lawyers kind of the liaison, so she’s also my in house kind of IT person, she’s she’s not directly writing websites, she’s not gonna like, she does little minor maintenance and upkeep. But she is she is the person that I go, this is what I need, and then she’ll go find out what happens and make it happen. So she is the get stuff done. person like projects, tasks. Almost anything that touches it will go through her. And then the other one is the keep people happy person. So there’s people think people employee and that processes employee, and together they’re my management.

Catherine Maley, MBA:  

But what about the money part? Because it seems to me with having such a big team, as a consultant, I would typically say okay, let’s break them into teams, by profit center, and then they will end we have a whole thing that I do on that when I go to a practice of like your size, we it needs culture, and it needs KPIs, and it needs processes, and it needs a lot more structure than that informal, because I’m sure 10 years ago, it was very informal, but did you start with a few people and look at you now can you just talk about your business structure because you have two locations and a whole lot going on? And I would like to ask you about your services as well because when I looked at your website and I saw that you have estheticians but even on services like spray tan waxing, I’m thinking is that really a good it’s not a good profit center I know that for a fact however it is if you can make assuming you’re going with that umbrella approach we are the One Stop Shop I’m assuming that’s where you’re going with that and I hope to guide your staff is really good at upselling cross promoting all services that kind of thing. But anyway back to business and how did you set all this up

Dr. Mike Nayak:  

just a little bit as time goes on there are updates almost every one of these positions becomes it’s not like you go oh I need one of these I’m going to make one and hit knee pain points arise and you go I really need to put a person in charge of this like we have a we have a purchasing inventory and fulfillment person and if you had told me five years ago I’d have a full time employee whose job is to do nothing but buy stuff no it’s stuff we already have and mail stuff out the door I’d be like you kidding me there’s that’s a full time job that we have it became evident maybe two years ago that we needed someone to we there be toner cartridge out for people in order and so and not only for people or there’s already one in the closet. So we have one in house four different people ordered it all for come in no one knows where they are. And it’s so we get to actually need as we find needs like that we create jobs. So when I first started I had one aesthetician and no nurse injector realized this was in 2006 when I started private practice. So I’ve known nurse injectors, I’ve one esthetician and that s petition was mean she would help me as a medical assistant here and there and in between things she would do non ablative laser so Missouri estheticians can do non athletic advices doing no facials, no spray tans, no waxing, it was the only thing she did service wise was non ablative lasers. And then she helped me as we grew and got a bigger footprint. So we’re in Missouri, we have based upon space phone space, the hardest part A lot of this is you’re kind of implying they’re just profitable and and less profitable offerings. So we’re always squeezing out the least profitable offerings and favorite more profitable offerings we had nails and massage for a while, but those got squeezed out baby brother things. The as we grew then we could we could actually take our estheticians and let them do other typical esthetics, things like facials like like peels like microdermabrasion all that kind of stuff back then was even pre micro needling which they can’t do in Missouri but it was just all those those types of things. spray tan one of my employees, I came to me maybe seven or eight years ago and said we need to do spray tans and I said just what you’re just just applied you’re crazy spray tans are not a profit center, like why would we do that? And, there’s every corner has got a spray tan operation on it. And so we did add it, it was actually i mean is it is it super profitable thing, no, but makes people happy that that the estheticians like to do it, we don’t do it at a price that that we won’t do it fo. So if they’re looking for ease and convenience, when they get their facial interest rate and walk out the door, we’re there for you. If you’re looking for the absolute cheapest spray tan you can get, you might want to go somewhere else. And so with it, that limits the number that we do, we do about it a value, value base number. And it’s been it’s been successful as a manufacturer right before COVID. We’re literally considering this is one of these things where I was just saying you kind of develop I think this is a job all by itself, spray tan tech, just a person, that just means the spray tan room, whichever one room in each campus, so we’d be to spray tan Tex just just to peel those out from the estheticians. And right now we’re not doing any spray tans, because with COVID I think that’d be hard to say that if that patient or that that employee was positive, I don’t care what kind of mask you’re wearing when you’re blowing that thing around the room. I don’t think that’s really controlling anything. So right now that’s on pause, actually,

Catherine Maley, MBA:  

What I do as a consultant, how I handle that, and I look at the revenue stream as you have built right now. And then I look at the counter to that. And I say, Okay, what if instead of you providing free tans and everyone’s everyone’s doing it already anyway, for another price? Would you be better off having somebody develop relationships and alliances with spray tan people, and let those girls be a good referral source to you. Same thing with destitution. Same thing with hair all of this. So is it better to do it yourself, or sometimes align with the neighborhood and not fight them, and not compete with them, but turn them into your ambassadors. And that’s how I never just be a numbers game and you just test it out and try it that way.

Dr. Mike Nayak:  

And then the the the intangible part of that is what makes people happy.    so it is not necessarily that the most profitable, highest profit per minute or square foot operation is also the highest happiness for staff and patients operation,   so we’re always kind of balancing. We’re like, what it’s like we’re in a grocery store and restaurant business for 1% margins, and,   we’re gonna live or die on some of these decisions, like staff members, loved ones, for example,   patients love getting them and we can,   we can do it. So I know, it’s just I know what you’re saying, like you, there’s certainly things that you can get honestly, like if I, if you really take it to the extreme, I should stop doing surgery and just make make my living through a 30 gauge needle all day and it might be more profitable. Happy. Yeah.

Catherine Maley, MBA:  

[inaudible] Surgical versus non surgical presenting?

Dr. Mike Nayak:  

What was that?

Catherine Maley, MBA:  

What are your revenues, percentage wise, surgical versus non surgical?

Dr. Mike Nayak:  

I can’t tell you exactly, but it’s majority non surgical now. Yeah, non personal. Because I do I almost exclusively operate anymore. But there’s, there’s one of me, and then there’s 1517 non surgical providers. So when you have one surgeon, and I, on a normal year, we would travel like,   1314 weeks a year. So I work about 75% of the time, and I do surgery with one guy. And then you have 17 non surgical providers that are more kind of, they’re all round more just just by numbers that that size is going to become the heavier side of that. But that’s by design, like I mean, I want it to be when I leave the office, that that we’re still doing just fine, you know that I’m not a slave to the machine that I built?

Catherine Maley, MBA:  

Well, I used to run a surgeon’s coaching club with William. Oh, yeah, upstate New York. And he always said, if you’re responsible for more than 27% of your revenues, and you’re not running your practice, like a business. And the doctors would say 27% Are you kidding me? I’m 97% of it,   and, but that was the mind shift change.   it’s time to look at your practice as a business and say, Are you able to walk away? Are you able to be sick? Are you able to go on vacation? Are you able to have an unforeseen incident happened like your house burned down?   that kind of thing. So back to the staff and, and talk about your business structure because you are quite a business there. You’re not just described your practice, physically and how it’s set up.

Dr. Mike Nayak:  

So we have two locations. Our main location is in front of Missouri, they’re both St. Louis. So one neighborhood in St. Louis. That location is 16,000 square feet and the ground floor 8000 square feet is all clinical. There is no office space, there’s no clerical, there’s no storage, it’s all clinical on the ground floor. And one half of the ground floor is my surgery center. And five or six exam rooms that I use when I’m doing pre ops and post ops and consults and that kind of stuff. And when I’m not in there, then sometimes my nurses like to spill over into those rooms and use them as injection rooms. That’s the half of the ground floor. The other half the ground floor is branded that army drums Bob brand. And it is all the non surgical. So toxins, fillers, devices, aesthetics, spray tans and that when they when we used to have them. And so that’s the other half the ground floor. So those are the two general pieces of the ground floor of that building. Our second location is about 3030 500 square feet. And it’s just an echo of the non surgical side again, same services. So that’s all the clinical stuff. And then on our back to our main building, the top 1000 square feet is our administrative kind of back of house area. So half of its dedicated to our call center and offices, and staff break rooms, Def Jam and that kind of stuff. And the other half is storage and shipping and receiving. So we have all of the all of the things that patients don’t need to see pulled up away from where the patients actually go. So they’re, it’s totally isolated from the rest of the rest of the practice.

Catherine Maley, MBA:  

Okay. And like I mentioned to you earlier, your office was eight miles away from the other one. So I said, what was the point? Like, why would you go to locations? Because I just have found that if the doctors not nearby managing things, and it can, it’s like the wild wild west, when in another location, you have to really know why you have another location, I guess. And a lot of them have another location 30 miles away because they’re pulling or they think they’re going to pull again, I’m just looking at those numbers. Is that working out? Or is it just a distraction or whatever. But for you, you needed to just because to address the demand? Is that right?

Dr. Mike Nayak:  

Yeah. So I know, with my house is actually halfway between both locations. So I got busy that way. We were out of space and out of parking at our private we’re still at a park in our primary location employees have to park off site, or at least 10 of them have to park off site just to leave space for the actual patients. Because we only have 40 parking slots in our in our lot. And so if you know we have close to 50 employees, let’s say 30 of them are working in front neck in any given day. That’s most of your parking lot,   so it becomes a problem. We don’t have public transportation in St. Louis. So that becomes a big problem. So we couldn’t actually see enough patient we could, we could we had more patient demand that we can handle with the staff that we could actually Park and with this is this is the this is the trip with. And so we have it we have a reciprocal deal with the building two doors down from us, that is a steakhouse. And they don’t they don’t open till 5pm. And we’re mostly closed by six. So we let them park their customers and employees that are late in the evening that we park villages, Part 10 of our employees that they’re like, yeah, that works out pretty well. But even so it was we still didn’t have enough space we had with patient demand for which we could add providers and providers require support people to make them efficient. We couldn’t do it, there’s nowhere to put everybody. And so we added the other location intentionally close because I was telling Catherine before this interview, I would have I would have added it in the next building over if I could have done it, it’s not about weed, it was not a way to get more patients to getting more patients have been really lucky with demand, it was a way to handle the patients that we are getting without making it feel crowded. And then hustle II bustling and congested This is all pre COVID This was 2016 when he did this, we it was feeling too crowded, and so the other location is not far away. It is it patients really don’t care which one they’re asked to go to because they’re so close to one another. As a matter of fact, you were talking about culture, so my staff is not allowed to work at one or the other location. So every staff member has to work at least one day in each location. So if it’s a three day week staff member at least one of those three days has to be on one campus and then the other two could be on the other they can’t be appointed to keep the staff integrated to keep the to keep them kind of knowing each other to keep them familiar with each other to keep have patients see familiar faces depending on where they go to keep the approach and and feeling and you were saying maybe we overused word culture I think but keep the culture the same. The two offices they don’t spiral off into two different directions

Catherine Maley, MBA:  

And it becomes that s&m thing and you’ve got to keep it together as a team you all have to be there for the good of the practice not for the good of gladness. Wow, if you can make that happen Good for you. Because it’s not easy to get some What do you call it herding cats or whatever, but hurting hurting cats?

Dr. Mike Nayak:  

Yeah, so if you have if you get a call from the other offices from someone you never see except the once a month staff meeting and you’ve never interact with them and you don’t really know who they are and they’re asking you a favor and you’re kind of busy and irritated. It’s easier to say no then if you see them once in a while and if you like them, either It’s not because you see them, you’re gonna say yes. Because you’re afraid you’re gonna see him. You’re gonna say yes. Because you become friends with them. You see them every week, you know. And so we there’s only one exception, I have one employee that only works at one office. And that’s a different reason for that. I can tell you that if you want. But–

Catherine Maley, MBA:  

Yes, we’re dying to know why he why she the entitlement.

Dr. Mike Nayak:  

She’s not entitled to saddled with it. If you if you do have this situation where, like I said, Everyone else is, is tasked with working on both sides, some point during the week, no one creates continuity at that second office. So there has to be someone that was there Monday and Tuesday and Wednesday and Thursday and Friday. So that there is a thread of continuity going through the week so that we know what happened yesterday. And we know what the issue was yesterday. And we know what we are expecting to happen today. And it’s too difficult to try to say, Well, I don’t servers Monday and Tuesday, and this one’s Tuesday and Wednesday, and then they’re going to pass along information. So we have one person there’s actually a medical assistant that is there five days a week. And she is the she is the continuity image inside that office. So that’s the one except

Catherine Maley, MBA:  

Total sentence Good for you. Yeah, that’s a great idea. Because they that that Us and Them thing is so it happens so quickly. You don’t even see it coming. But then as a consultant, when you’re called in, you can hear them saying, well, they can   you can hear that and you’ve done a good job of keeping everybody integrated. Is there any kind of bonus structure? Or is it do do they win as a team? Or do they win individually? How do you keep everyone motivated?

Dr. Mike Nayak:  

Without going into great detail? I used to do the Add Williams bonus structure, I did this. I started practice private practice 2006. And up until 2010, I did the Edwin’s bonus structure, which is bonuses are based on. And he may no longer do this anymore. But bonuses are based on how this quarter do versus the same quarter last year, what’s the incremental growth and based on that incremental growth will create a bonus that shared equally based on like how many full time equivalents you are,   if you’re a full time equivalent, you get a full share of the bonus pool. And if you’re a half of a full time coder, you have to share the bonus pool. And I did that for the first four years that I was around. And it worked. It worked well. When I moved from the office, I was in then to my main office, now we took a sudden increase in Alright,   I moved from a single 3500 square foot office and a not so nice building to a 16,000 square foot building in the nicest part of St. Louis. And so what I said to those employees that were with me at that time was I can’t guarantee that you’re going to earn a bonus at all this next year or two or three, because I don’t know that we’re going to have year on year growth rollout like I because they all have a center our exam attire. So it is nice to increase all their base salaries by the equivalent of the bonus they would have gotten. So if they got, let’s say if the average bonus was $1,000 in that quarter, that’s $2 an hour,   such $1 base salaries a bump in $2 hours. So this is your I’m going to guarantee you get that. But we’re killing that bonus plan for a little while because it didn’t. I didn’t know who the worker is.

Catherine Maley, MBA:  

So what happened? How did they How did that go?

Dr. Mike Nayak:  

Oh, they love that they got there, they got their quarterly bonuses if it was a good quarter, just built into their payroll that was on   so basically, I said, I don’t want you guys being penalized because we’re taking the risk and

Catherine Maley, MBA:  

Into the productivity and the attitudes still stay high?

Dr. Mike Nayak:  

iI did, it was easier with the small team, you know that I had like seven or eight people. So it’s easier with a small team. And as we’ve added more providers than we then started put bringing back in more incentive structures that are person dependent. So when we as we as we reintroduced incentive structures, they became tied to personal and professional revenue, personal productivity, which requires really mature employees,   so the good thing about the team approach is that it doesn’t matter,   who’s played the bone lands on   at some point, the end of the day, it’s all split up, everybody’s happy. The bad thing is the high, the high producers, even if they’re not bitter, they’re not they’re not elated,   because you’ll get 10% of the extra revenue that I generated. When it’s more individually driven. There’s less bitterness from the high producers. And there they really feel like they’re, they’re gonna see they’re gonna see reward directly based Based on their own efforts, which I think is,   it’s kind of a meritocracy in that way. But you have to make sure you’re hiring people that are not going to sell stuff. That’s not. That’s not right, you know that really a patient’s best interest at heart, you have to have a really good team, let’s say on my injectors,   someone comes up, they need a Botox touch up or something else, but they weren’t the one that did the Botox. They really have to have a team spirit, because sometimes I’m going to help your patients, sometimes you’re going to help my patient, we’re not going to keep track, we’re not going to,   do micro math to try to figure this all out. This is one of the benefits you have of being in this practice. And it’s one of the burdens up there there and being in this practice, and if you have if you’re that picky about every little move needs to be compensated,   you’re not welcome here like we have a it’s It is, it is capitalist, but there’s a little bit of a socialist underpinning, like we’re all in this together. And you can’t be you can’t be fat, neurotic about every little diamond dollar.

Catherine Maley, MBA:  

I’ll tell you, there is no answer. There’s no one answer to this. And you have to know your personalities they can have on board, but I will tell you, as I always, my whole thing is finding rockstars the problem with a rockstar is they don’t want to work with losers,   they don’t want to work with mediocrity. And trying to balance that out is killer, because on the one hand, when they plan as a team, and work together as a team and celebrate together as a team, then they’ll hold each other up, they’ll hold each other accountable, like the one that’s,   not doing their fair share, they’ll call them out. But But if you have that Rockstar who’s like the untitled one, like I don’t coordinators, quite frankly, I’m have a very strong sales background. I’ve never gotten a paycheck, I’ve always worked off conditions. I’ve never gotten paid unless I produce period. And but but I’m not a good team player. So   you’re trying to figure that out. So if you want somebody to crush it, but they’re not going to play well with ever with the others in the sandbox, and you have to deal with that. And when you have a team is bigger shores, and cultures everything for you that   their Lord, like do you have like team get togethers? Or how do you keep everybody motivated? Because if you’re running this machine and all sounds like a machine, you’ve got a busy busy practice there. Is there any burnout? Or how do you avoid it?

Dr. Mike Nayak:  

  every everyone has bad days. I mean, it’s, I would be lying. So it’s just utopia. And everyone’s smiling always. We’re really lucky, though. I mean, we’ve had a couple bad hires, and the bad hires don’t last, because exactly what you’re talking about whether they’re not hard enough workers have the wrong attitude, or they just don’t we take our hiring process very seriously, we sometimes still get it wrong. And you’re absolutely right, it becomes painfully obvious in the first few weeks of this is not going to work. And so part of I think, part of having a good culture is actually,   there might be two or three people that are pretty well qualified, but you’d go who’s actually going to be the, my every hire, my concern is we’re going to break it, like who’s gonna break our system,   like I did. So hiring is important as far as our people together and   pre COVID, we used to do our at least quarterly little,   fun events and that kind of stuff. And I’m not exactly sure how we’ll do that in the next night.   COVID is not gonna be around forever, it will be sometime between six months and six years from now, it will be all over. So we will have group events again. I just, I don’t have a great answer for why for why the culture is as good as it is, I think,   we treat them really well. They treat each other really well. And they really do. They really do celebrate each other’s victories, and they really do look out for each other’s problems. When it comes back into our office manager, who again is the people person in my practice she she’s got her finger on a lot of it. I wish I could just tell you, this is the secret sauce, but there isn’t one.

Catherine Maley, MBA:  

Do you stay out of it? Mainly, do you stay out of it and let that right hand person handle all the staff issues? Can anybody get to you?

Dr. Mike Nayak:  

Well. So it’s it’s a, it’s a balance again? So I try to I don’t make it to the satellite office when it’s open? Hardly ever. But that’s okay. Because I see all those employees every week when they come to the main office. I don’t physically get into satellite office when it’s open hardly ever. But anytime I’m free, I mean, I you’ve heard the phrase managed by walking around like I literally walk around the building just kind of leave,   say hi to people just kind of look at people’s expressions kind of take their take their emotional assessment, just kind of see how things are looking and feeling. And so I’m all over that building, both upstairs and downstairs many times every day, as are my managers. And Can anyone get to me sure anyone can always email me or text me or or   walk in my office. But the reality is, that happened more when I was 35 and had six people. It’s a little kind of bittersweet because as you get to be   late 40s and have more people Do you want to be best friends with everybody, but they don’t necessarily want to be best friends anymore, because it really is a boss versus employee thing. At some point,   there’s it no matter how much you like each other, there’s still that little bit of a bump. And so a lot of them actually do feel much more comfortable talking to my office manager,   we actually have a structure within that. So just like, it would be impossible for me to directly oversee 45 to 50, people that report all directly to me, it would be impossible and unrealistic for me to expect her to do it,   so be under name is Allie. So I can’t say Allie, you need to directly oversee every one of these people, let’s not,   big trees don’t have leaves coming off the trunk,   you have branches, and stents. And so we have a leadership structure within each group. So each of our departments is kind of a department head. And so the department head is not a paid position, it’s a position you get if you want, and if you if they think you’re the right person for it. And your job really is not to boss around the other receptionist, your job is to bring to Allie and bring to me things that would make the receptionist job easier.   so it’s not like, I’m here to tell you how to be your job better. It’s, I’m here, maybe a little bit of that, but mostly,   we noticed the receptionist struggling with is all the batteries are dying on or whatever, or the   the printer, is it ridiculous or,   can we fix the process for new patient paperwork, like basically, the kind of a mouthpiece of each individual or session, it doesn’t necessarily have to come upstream.   I mean, they’re welcome to, but they’re there. Their department head is the one looking out for them. But it’s also She’s also the one that   Valley needs to get a message out to all the receptions directly, emails are not super efficient, or   what’s actually not super efficient. So she’ll talk to that department head, and say, make sure that your team knows this. And then that gets that gets fed out. So it’s a it’s a funnel, both directions and communications funnel. Each our medical assistants have a department head or or team has one or nurse injectors have on restitutions have one, our reception team has one, our console coordinators have one. And so once a month, we actually have just the department heads. So we have we have a staff meeting monthly, which is just under an hour. And we actually ask everyone to come to it. And this will probably be virtual for a while here. But we have a staff meeting monthly. And then staggered two weeks, is the monthly just department head meetings where we just bring in the the kind of runners of each department and talk through things that we might implement things that we don’t want to tell when you have a group this size, you don’t want that information getting out half baked, because it just makes everyone anxious,   and you let out half baked ideas. So we take our half baked ideas to our department heads,   what do you think about this before we let them out to greater things.

Catherine Maley, MBA:  

Wow, did you take a lot of leadership courses? How did you know how to build this business structure?

Dr. Mike Nayak:  

I have a lot of good friends. You mentioned Ed Williams. So, Ed Williams is a phenomenal leader. There’s a guy in Michigan chip mock that is he built a huge, huge multi multi multi arm practice I I like to go visit people’s practice. And I used to two or three practices a year I go visit either because there’s something surgical I wanted to see or in chips case, it was a response that we rent as a business. Nick brandy, I know. He’s a top $5 game account. He’s in Pittsburgh, his practice is called the skin center. Nick and his brother Jerry, Jerry runs the place. Nick is the primary surgeon, although Nick is retired now, to get the top $5 again, account, like five or six satellite offices,   multiple injectors, that kind of stuff. I’ve had friends that have been here before me. And so I have not taken any leadership courses proper. I probably should probably be better–

Catherine Maley, MBA:  

Visiting and role modeling others, that’s the best shortcut on the world and the best, like on the streets,   experience you can possibly get so good for you for visiting others. I think it’s a great idea. And we’re gonna switch gears now and talk about marketing because either you’re in the best location on the planet, you have no competition by you or St. Louis, like be pleased to be four. Because everybody I work with has so many competitors nearby and they don’t have a big flow of patients like a never ending patient. Not many, not many complained about. They have too much. And I’ll just put it that way. So how are you making that happen? You’re making that happen. By the way, it’s not just happened by accident. So you must have quite a marketing machine out there working–

Dr. Mike Nayak:  

Great. I think we’re lucky so we do have that Again, we do significant competitors there, we were really, I mean, I don’t remember what the data is, but per capita, St. Louis is like, it’s definitely top 10 for for cosmetic surgery per capita, as far as how many people inject your work, it will open St. Louis for definitely top 10 which you would not expect, but but we are a lot of it comes down to messaging. So   I really focused really hard on, on the surgical things that I do. And we’re trying to message this expertise and technical excellence, and that kind of message goes out. And at the same time, it’s like every practice at the same time, we’re trying to message that we are friendly and caring and approachable and,   the kind of people you want to be with, even if they’re not working on you,   we’re trying to message that. And then,   his social media has come out. And it really lets people get to know me a little bit and my practice a little bit. And,   by the time people contact us they’ve already committed like, but they really, there’s not a lot of selling by the time that contact us they’ve sold themselves watching, just watching for a year or two,   and then my providers all have their own social media, and this is always a point of contention with with a lot of my colleagues is, is should the providers be allowed to post pictures to the providers have their own socials to the provider, social media, super branded with your practice? Hey,   it isn’t like, it’s kind of a weird competition,   like, within a practice,   like, I would love and it’s happened, I,   I want people to come ask for my injectors over me, that’s my goal,   because only I can operate,   and they can inject and they’re fantastic. And my goal is to obsolete myself in that I have friends that hire Junior associates or injectors, but they can’t let the patient go, and they come in, they want to do it. So it’s like, you have to, you have to be able to, like, give things up to and that’s a large part of that whole leadership thing is,   I don’t micromanage every little decision, I a tiny bit more about the leadership and mentor if you want, but I give, I give direction to my team in the morning that I’m sick that I’m out of it,   so every morning best practice administrator, practice manager and I, we do basically a morning stand up,   we’re together for 15 to 20 minutes, where we review our active atoms lists are kind of Sunday items list, make our decisions that are past review or data, and then I don’t see him till the next morning. But they have a course for the day, they know exactly what they’re doing. And I’m out of it. I let them do what they do. And then we reconvene next morning. So it’s the same thing with like this, we bring an objective bring an aesthetician I, if you look at any of my people’s accounts, they’re very autonomous. I mean, I kind of alluded to I’ve been in private practice since 2006. But I was in university practice for two years before that. And the thing that made me leave University practice was not money. It was just being suffocated. I felt like I could not develop as a surgeon, with all the,   they’re trying so hard to confine me to do to not leave, I was like, I can’t be here, you know. And so, I’ve given them, given them, they have lots of autonomy, if I didn’t make them better, behave within certain bounds and be respectable, but they’re good human beings so they do that anyway.

Catherine Maley, MBA:  

[inaudible 49:39] not built into their social?

Dr. Mike Nayak:  

Not significantly. I mean, often the like, you’ll see like, our logo on their scrubs, or,   if they have, if they have my social person produced a video for them, our logo may appear somewhere, but we don’t really, we don’t really demand or enforce,   if you put out a piece on social that you have to say you work here, and I mean, just put out the piece, you know. And that’s, that’s been really helpful, too. So we don’t have one voice out there trying to bring in people and I’m doing it, but people love their providers and their providers that they love, get other patients that get referred directly to them because they love that provider.   they’re they’re not just there to help handle the work. They they actually generate income incoming patients on their own too.

Catherine Maley, MBA:  

For sure. And are they good about cross promoting to you, like do all arrows point to surgery or no?

Dr. Mike Nayak:  

So yes, when when it is a patient that is not best served by surgical treatment, they’re certainly not gonna refer to another facial plastic surgeon. They’ll certainly refer to me. But that’s but like the goal isn’t. We built our surgical practice backwards from the average. So I think that the conventional thinking is, this is all pre social media is,   you get people in the door, something easy and cheap, like an injection. And then,   hopefully they’ll convert the surgery someday. Pre social media,   I’m thinking I’m spending 20 $500 on this Magazine Ad or $20,000 on this billboard, I want to generate a $20,000 facelift, I don’t want to generate a $200 injection, you know. And so we built our spa side backwards. So when we started, it was just a surgical practice. And every message I put out there was about surgery. And by the time I got them in, operate on them, now, going forward, retaining them with their, with their injections, appeals lasers, and that’s easy. they’ve, they’ve already made a big commitment, big decision to have surgery. And so it’s not like we bring people in for injections, hoping that we can revert the surgery. The injections are there. They’re their own. And they’re their own goal. The   a lot, a lot of people that are having injectables and lasers and non surgical treatments are not going to be surgical candidates, maybe ever. And that’s not on the horizon. And that’s not what they want. It’s not what they need the other there. It’s a different,   it’s a different world, like when we first started in this industry, plastic surgery was about fixing a deformity, or reclaiming your looks from when you were younger. There’s a whole third arm out there right now, which is I’m not deformed, I’m not ugly. I’m 19. But I want to look amazing,   it’s kind of living your best life blow up optimizing these, that category didn’t exist,   15 years ago. And so it’s also the fastest growing category, and they’re probably never going to become searchable.   they’re mostly injectable. So it’s not like every time we bring an injectable patient, we’re thinking how are we going to encourage them to surgery perfectly happy with the [inaudible 51:53].

Catherine Maley, MBA:  

What is the goal is to keep them under an umbrella, to keep them under your roof?

Dr. Mike Nayak:  

Absolutely. So that’s back to let’s say spray tans or,   some of the facials or waxing,   if there is, again, I have employees that enjoy doing those patients do need those services are going to get them somewhere, and they are going to get them somewhere. And when they go to that place, it is also the lowest profit center in that building too. And they’re going to do their best to keep them for something that has a higher profit center, such as,   injections and lasers and everything else. So there is part of that part of the reason we offer those is specifically so they’ll have to walk into another door.

Catherine Maley, MBA:  

Gotcha. So for marketing channels,   it’s funny, you know how I first found you, when you first came on my radar, I fly more than 100,000 miles a year or used to anyway, and now I don’t go anywhere. But I saw you on the airplane. So American Airlines magazine, and it was the top stocks. And I thought oh, and then I remember I always look at that now. And I think you guys this is really work. And what I’ve noticed is that there are different reasons for doing it. It’s very good for branding, I will say that. I don’t know how many people are in the air saying, Oh my God, I’ve got to call that guy. I think it’s not an easy street shot,   looking at the magazine and getting into your office, I think is a long road. But I do like the branding part of that. So, for marketing channels, you’re using that one, but did you get into the PPC and and all of that, like how are you marketing yourself?

Dr. Mike Nayak:  

We currently do no PPC

Catherine Maley, MBA:  

Did you use to but didn’t get good results or what?

Dr. Mike Nayak:  

Well, so I’m going to break this up into pre social media and post social media. Pre social media. When I first started, I literally did newspaper ads and they were effective. Like in my in my opinion, the ad has no matter what the vehicle is, the biggest piece of real estate is taken up by before and after picture. And what you say underneath absolutely doesn’t matter. Like it’s fewer words. So those are gone. Now the only paid advertising we do is we do that. Yet we voted into top dogs. But then once you are, you know when when those slots open up you can have on those. So we do those that’s kind of an image advertising piece, just and I know you know what image advertising is. But for the listeners, it’s not intended for them to look at that and go, I’m going to call his office, it’s intended to boost your reputation. So that when they’re finally in the market, they’ll have been messaged 678 times or so. And that’s a friend,   who should I go to for my facelift. And if they haven’t mentioned my name, he carries way more weight than if it’s the first time they’re exposed to it. Or if a friend asked them who should I go to for my facelift and they probably spit My name out just because they’ve seen it that many times. So it’s image advertising. I think it helps. We do that as a paid ad. And I do some been doing this about five years, six years billboards in St. Louis.

Catherine Maley, MBA:  

I posted billboards in certain areas, they work beautifully.

Dr. Mike Nayak:  

So and literally my billboards have two pictures and three words On, they have a before picture and after picture as big as they can possibly be. And at the bottom, they either say neck by niagra, nose by neck, and there’s nothing else it was over just two pictures in three words, no contact information and nothing. And I started that with those are the first time that I started using those two phrases was on those billboards, pre social media. And I knew they were working because if you start typing phrases into Google, there’s a thing called a longtail keyword will it will complete it will start to complete what you’re typing for you do not talking about. So it got to the point where I’ve not popular those phrases anywhere else. But if you sat down and started chopping nose by Google with longtail keyword complete Nyack before you hit Search, it’s not like where you’re on the results. It’s predictive text, or neck by. And so when I started seeing that behavior, I knew that people are literally looking at billboards and then going home and typing that phrase, because those phrases come up based on consumer behavior, you know. So those are the only two paid ads we do we do. That magazine, and billboards. Everything else is social. You had mentioned and not paid social, organic social. You had mentioned pay per click. I am a bad person to ask about that. The last time I used it was like 2010, maybe. And we will probably use it again soon for other things. But we turned it off because my wait time this is before we were handling our incoming console. inquiries. Well, so at that stage, if you call my office for a consultation, there was no pre education. There’s no screening, when do you want your console? Okay, sticky on there. And so we’re putting a lot of non starters onto my console list. And so my new console wait time, two and a half, three months? And which is no good. It’s horrible. Because the the serious patients can’t get on the schedule. The ones that do Book Three months from now they have some of them had their surgery by the time their console roll, we call them up be like, oh, we’re missing your console today. And it should say I already have my rhinoplasty. I’m so sorry. Yeah. So we’re totally mismanaging it. But we turned off Pay Per Click so that we could,   get that get the increase down a little bit, that didn’t change a thing, like our number of inquiries coming in totally unchanged.

Catherine Maley, MBA:  

Where are the leads coming from osmosis or what? Where are they coming from? You’ve got SEO, do you have a good SEO guy?

Dr. Mike Nayak:  

Our SEO is good. So if you search for things that matter to me, we placed Well, we placed well on Google, for SEO as good as our word of mouth is good. Like right now, I’m not just saying this, I think in St. Louis, if you were to ask people,   looking for a guy that does noses or facelifts and might not always be the first thing that they’ll say, I’ll be in the top two or three,   so I’ve been here long enough. I think that helps. My, again, my actual providers have have really meaningful reputations of their own. That really helps. And so just just literally organic, not even online, just person to person.   Corona style transmission is is huge. And it really works. And then social, social, you can’t you can’t underestimate it, it’s very powerful.

Catherine Maley, MBA:  

And are you able to track it? Do you have good systems in place? Do you know somebody actually came in from social? I talked to people all the time. And here’s what happens when you when I do a lot of phone training for staff. And we always ask them, so tell me how you heard about how did you hear about Dr. Nayak? And they’ll say, Oh, the internet or Instagram, let’s say, and then when they get to know the patient better, it turns out the girlfriend mentioned you, then they went to Instagram, then they went to your website. So it’s got it’s got really complicated to find out the path way to you, but are you do you have a good handle on it?

Dr. Mike Nayak:  

No. And it is just a just as you said, I think it’s artificial to say,   it’s almost asking. It’s like man in one ingredient, a recipe. they were touched by six different things. The airline flight, the billboard, their friend mentioned that they saw on Instagram posts,   so even if you were doing pay per click, and you had a direct track from that click, it doesn’t tell you anything more than that was the last time that   so. You don’t,   we used to do tracking phone numbers. When I did print ads, I’d be tracking phone numbers of different phone numbers for different different ways into practice. The closest again, the closest I can I came to being able to see something really made a difference was when I put those braces up on the billboards. I wasn’t using on social I didn’t have a printout. It didn’t have anywhere, but it changed Google’s predictive behavior. So I knew those were dry. I knew people were responding to that. But that’s the closest I can tell you that.   we don’t we don’t really we ask it on our intake sheet and don’t miss one thing. But I don’t know.

Catherine Maley, MBA:  

Okay. Do you have any idea what your marketing budget is? Is it like a percentage of GDP as a formula? Or do you just spend what you need to spend.

Dr. Mike Nayak:  

I,   I’ll tell you I spend about $80,000 a year on billboards. So about 20,000 a quarter. And then I think the, the top box runs about 3000 a month, something 3500 a month, maybe something like that. And that’s it. That’s my marketing budget.

Catherine Maley, MBA:  

Okay. All right. Let’s see what else for cuz I love to talk about marketing. And, by the way, how much time do you spend on social media?

Fair amount,   it’s funny I am, when I first started, Facebook’s probably close to seven or eight or nine years ago, I did it solely, it was actually at an ACS meeting one of the ones in Orlando. Yeah. And I remember thinking, I need to do a business page,   and you can’t do a business page without having a personal page. And so like, Alright, I’ll sign up for personal page, just build a business page. And that was, that was a bad idea. And I do, I do spend a fair amount of time on it,   but I do think it makes people feel connected to you as well.

Well, at the meetings,   now we talk about social media all the time, at the practice management sessions. And some of the doctors are spending hours, hours, hours,   five to seven hours a day and, and I used to think that Are you out of your mind, don’t you have something better to do, but it’s just, it’s just the way life is now, you have to market you. And it takes you to do that,   because now wants to know who you are. And that’s why they’re going to social, they want to see who you are as a person. And there’s no way around it now. So you’re the you’re the marketer, and the and the the manager and the surgeon, and oh, my God, dish with a bottle washer and all that.

Dr. Mike Nayak:  

I would say one of the things that I’m still having a really hard time figuring out is, as you said, You can’t do it all. And I have Jenny, who is my social media coordinator, who I love, and she’s fantastic. But you can’t have them kind of run it either. Because it’s not authentic and people don’t like watching it. You know. So it’s, it’s a, it’s very interesting, I think you can probably look through my posts and reading the tone, you can tell when Jenna posted something when I posted something, and that is probably not good. I know. It’s, it’s, I know, it’s definitely not good. Like, if I did if I wanted to be really effective. I would do more of it. And she would do more on the kind of production and then I would do more in the posting. But it really comes down to just time and desire and demand. Like what what exactly is that going to aause? You know, a lot of times like, couldn’t you brought on a partner? Couldn’t you? Do you know more surgeries and, or whatever, and dad, but what exactly how’s that gonna impact my life,   it’s like, or bring on another surgeon and pay them what they’re worth, and keep them happy. And bla bla Great. I’ll make 10% more in a year. With 100% more complication and stress and everything else. Like is that really worth it?   I mean, so there’s, there’s always like the second, it’s not always just about the revenue piece, but it’s about just happiness and longevity is a big part of how I run the practice.

Catherine Maley, MBA:  

I know your cat. He’s been an Instagram. We’re lucky. We’re see. Hi. This is Rocky. All that is so funny. I think I’ll get my dog. Where’s my cat? Come here? No, I, I’m adorable. And actually, I was gonna ask you about that the business model? Are you trying to scale? Are you Where do you want to be? Or has COVID changed any of that for you like, what your vision is?

Dr. Mike Nayak:  

Right before COVID we were looking for a third location. Hopefully, we are maxed out about places right now. Right, right before COVID. And you’re gonna think it’s crazy to do the same thing. We’re literally looking for a spot that was not that far away. Just to just to take overflow. And obviously that got put on hold. I’m content,   like, I’m happy with how things are right now. I think I think we’re going to give it like I said sometimes in six months in six years from now we’ll have this COVID thing figured out. So I just kind of want to see how things play out in the next like we don’t know what’s gonna happen in the fall. We don’t know what’s gonna happen,   next spring. So I think right now it’s more just kind of be thankful and be content and   enjoy where we are for a little while mode in which it seems you can tell us about like to take any classes or I’ve had pretty good intuition about when it’s time to do something,   and I’ll know when it’s time to do something.

Catherine Maley, MBA:  

Okay, just out of curiosity. Give me one big mistake you made but that you learn tons from.

Dr. Mike Nayak:  

I hired a an injector one that was a terrible fit culture wise. But I didn’t know it because I was so enamored as a person with that with that injector, and I was like, This is gonna be great. I mean, hardest working person you ever met, and had such a desire to be a part of the practice, I thought that was gonna be amazing. And there were some subtle messages from my staff that this probably isn’t going to work out. And I didn’t, I didn’t listen to him. And it was a tense, month and a half. And then,   nature took its course, everything is fine. But, and what’s funny is I still the individual, I still think the world of,   but it was it, I could have seen it coming. If I had paid more, pay more attention, if I hadn’t been so confident just based on the person, how wonderful the person was, if I hadn’t been so confident that we’ll kind of over   and I really should have, I should have seen that coming. And all the other ones are related to patient, all the other ones are like 100% of them are thinking that patient’s going to be happy,   they’re, they’re just weird, they’re going to they’re nice, that’s going to be fine. And then, and then they’re just as crazy, if not worse after you operate on. So those are the big ones usually is patient related.

Catherine Maley, MBA:  

I actually surveyed several doctors about that you know about the patient selection and they said I had a feeling and   I had a feeling but I said I can handle this it can be that big of a deal. Well, I will be fine and also fine, but and then on the other one is I should have listened to my staff because they told me they gave me a heads up, and I thought I could handle it.

Dr. Mike Nayak:  

Yeah, I’ll tell you one of the probably the best thing ever did, though, is fixing that console process fixing the new inquiry to getting in front of me. The process between A and B. Mm hmm. That was probably the best thing that we ever did in terms of making, making my time or more valuable. or making the most out of my time.

Catherine Maley, MBA:  

Yeah, for sure. And then the last last question, what’s something that we don’t know about you that’s interesting.

Dr. Mike Nayak:  

Interesting? So you know I cook.

Catherine Maley, MBA:  

You cook?

Dr. Mike Nayak:  

You don’t follow my social at all. I love to cook, that is you– look through my social look for cooking with Mira

Catherine Maley, MBA:  

You know whats funny? I don’t cook so it doesn’t even register for me. I don’t even see anybody. I can’t even see people cooking because it’s so not what I want to do. Are there some specilties, do you have a certain dish?

Dr. Mike Nayak:  

I cook everything, I love to cook more complex the better I enjoy it. So that’s one thing. Do you know I– I still sing at a fair amount but I used to sing a lot.

Catherine Maley, MBA:  

You sing?

Dr. Mike Nayak:  

I was like a semi professional kind of music.

Catherine Maley, MBA:  

What type of music?

Dr. Mike Nayak:  

 All acapella. All men’s acapella.

Catherine Maley, MBA:  

Can you try a few bars?

Dr. Mike Nayak:  

Nah, I need a group. I’m not I’m not a good soloist. But, but my college group toured the world singing legitimately.

Catherine Maley, MBA:  

Oh, you have something to fall back on if this doesn’t work out. Just kidding, right?

Dr. Mike Nayak:  

Yeah.

Catherine Maley, MBA:  

It came back together. Yeah. put mine out on the road when we can travel again.

Dr. Mike Nayak:  

Yeah. What else? That’s those? I guess those are two, two trivia things.

Catherine Maley, MBA:  

Wow, that’s very interesting. And any last words of wisdom for anybody?

Dr. Mike Nayak:  

Yeah, so I’d say another really good thing. If yes, like one of the best things I’ve done in terms of building a practice is, when a staff member comes to you and says,   I don’t think I should be doing the job I’m doing. This is what I think I should be doing. I’m almost always the right choice. So when when someone says,   I don’t think I should be doing this reception job,   I really think is there, here’s this other, I’m literally going to describe this thing where I think I should be studying and doing this thing. Almost always, especially if it’s a good employee and someone that has, has the practice interests at heart and is genuinely dedicated person. Just say, Yes, just do it. Many, many, many of my people are not in the seats that they came in, when they first when they first boarded the bus. And many of the seats that they have, are currently occupying didn’t exist when they boarded the bus, and they are built for those positions. And so I think that’s if someone comes to you with had this crazy idea,   I want to do this, I want to do this. Don’t dismiss it.

Catherine Maley, MBA:  

So, so true. And people grow, people learn and they grow. And that’s how you have an aesthetician who ended up in upper management. Some people are they rise, they rise to the challenge and you just have to be sensitive to that because if you hold them back, they’ll leave or they’ll create havoc,   and it turns out it’s they don’t have a bad attitude. They have a bad attitude about what you’re making them do.

Dr. Mike Nayak:  

I mean that’s why I left the practice I was at for two years is I could not develop. And, sadly, this this happens once in a while too. And,   people ask about Aren’t you afraid your, your people are going to leave? And the answer is, yeah, I’m terrified My people are going to leave, I’m always worried they’re going to leave it doesn’t mean   they they could,   like, so I tried to make the environment so good that if they leave, it’s not for something I could have controlled. And I think I think the most common reason someone would leave is almost what we’re talking about right now, they’ve evolved beyond what what they’re doing, and there’s no word, there’s nowhere for them to do more. Or I am. So   there’s certain positions where they might be super, super triple rock stars, and they’re amazing. But the next slot up needs a license for the next, the next office up is occupied by someone that’s great. And it’s going to be there a while. So,   sometimes people leave because,   it’s not all about you, it’s about them,   their life is developing and their career developing and,   sad, but sometimes where they need to develop into doesn’t doesn’t exist in your practice anymore.   and so,   it’s just kind of have to accept that that’s gonna happen sometimes. I hate it when it happens.

Catherine Maley, MBA:  

But that’s life in business. what I find more of, is having somebody there for 10 years who should have been gone eight years ago, I see that way more often. And nobody realizes how much toxic energy goes into that. Somebody who won’t grow, who won’t learn who won’t develop I, I find that way more than I find that one rock star who is being held back.

Dr. Mike Nayak:  

We face that too. And it’s always there. It’s always a very emotional and difficult, difficult separation at that point. Because they take it very, very personally.

Catherine Maley, MBA:  

All these people are people and just working with people. It’s a challenge in itself. So I didn’t realize, so leave everything at this for a long time. It’s really nice. Very interesting. All right, everybody, I hope this was helpful to you. Please subscribe to Beauty and the Biz. And leave me a good review. If you like what you hear here. We’d love five stars. And then of course, share this with your colleagues and your staff that helps them grow and learn. And then of course, if you ever have any questions or feedback about Dr. Nayak and what he’s up to, oh, how can we learn more about you? Where can they find you online?

Dr. Mike Nayak:  

Well, so my website obviously my plastic surgery is a good start. or on Facebook or at my plastic surgery or an Instagram right and I have plastic surgery and on YouTube, guess what? Plastic surgery?

Catherine Maley, MBA:  

Good. You grabbed all of them, good for you. And then if you want to um, check me out on Instagram, I’m catherinemaleymba. Thanks so much and take care.

Catherine Maley

Catherine Maley

Catherine is a business/marketing consultant to plastic surgeons. She speaks at medical conferences all over the world on practice building, marketing and the business side of plastic surgery. Get a Free Copy of her popular book, Your Aesthetic Practice: What Your Patients Are Saying View Author Profile.

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